Psychotic symptoms during phenibut (beta-phenyl-gamma-aminobutyric acid) withdrawal

Abstract

Background: Phenibut is a GABAB agonist that was developed in the Soviet Union in the 1960s. In Russia, it is used in clinical practice to treat, for example, anxiety and alcohol withdrawal symptoms. In Europe and in the United States, phenibut is marketed as a nutritional supplement for improved sleep. In different Internet discussion forums, there are several reports of withdrawal symptoms. Aim: Our aim was to share what we have learnt from a case study wherein a patient was followed throughout the whole abstinence period.Case report: A somatically healthy man in his mid-20s with a previous history of substance abuse took phenibut for 2 months. He noted tolerance development already after the first week and increased doses up to 20 g/day. Already a few hours after the last dose the patient started to experience subjective symptoms, at the third day of abstinence the patient started to hallucinate and the following day’s symptoms were aggravated with increased hallucinations and confusion. After treatment with benzodiazepines the psychosis resolved.Conclusion: Phenibut withdrawal symptoms can become severe and have similarities to Baclofen, GHB, benzodiazepine and alcohol withdrawal. Benzodiazepines and supportive care seems to be the most effective choice of treatment for objective abstinence symptoms.